Breast cancer treatment has come a long way in the past decade, but researchers aren’t about to declare victory. The disease claims too many women and affects too many families and loved ones. So physicians and scientists like City of Hope’s Cathie Chung, M.D., Ph.D., press on with their work, seeking more powerful treatments, improved preventive measures, earlier detection and, ultimately, a cure.

eHope: Are there any new types of medications coming along?

Cathie Chung, M.D., Ph.D.: Yes, there are many new agents being evaluated for the treatment of breast cancer. Most of these agents are targeted agents aimed at blocking specific biochemical pathways involved with breast cancer. Some of these pathways allow the cancer cells to grow, invade or spread, while others interrupt the body’s normal ability to detect and kill cancer cells before they get out of hand. At City of Hope, we’re actively engaged in clinical trials to assess the efficacy and safety of new drugs for treatment of breast cancer.

Cathie Chung (Photo by Paula Myers)

CC: While the development of aromatase inhibitors has greatly contributed to the treatment of hormone receptor-positive breast cancers (those that grow in the presence of the hormone estrogen), these drugs are not the be-all, end-all of treatment for patients with this type of breast cancer.

There are very complex interactions between hormone receptors and other molecular signaling pathways, and these interactions allow breast cancer cells to develop resistance to anti-estrogen therapies, including aromatase inhibitors. The key is to develop strategies that allow hormone receptor-positive breast cancer cells to maintain their sensitivity to anti-estrogen therapy, thereby prolonging the effectiveness of these drugs. City of Hope researchers are working hard to develop such strategies.

EH: Are there any new strategies for combining types of therapy — teaming up radiation with chemotherapy?

CC: I would say that there is not a lot of emphasis on combining radiation with chemotherapy for breast cancer. We are looking at this more for other cancers such as lung or gastrointestinal cancers, like liver and pancreatic.

EH: What treatment trends do you see coming down the pike?

CC: The major trend is to try and individualize treatment decisions, for both early and late-stage breast cancers. Such personalized medicine will depend on our ability to identify which biochemical mechanisms are responsible for the growth of a patient’s own unique breast cancer and choose specific drugs to block or deactivate that specific pathway. The ultimate goal is to maximize the impact of therapy on the cancer while minimizing toxicities to normal, healthy tissues.

EH: What's it going to take to get beyond just extending life and actually curing more women?

CC: Statistics show that we are already improving cure rates for women with breast cancer, as the number of breast cancer survivors has increased over the past several years. Can we do better? Absolutely, and as before, this will take a multipronged strategy, some of which is based on what we know has already worked so far:

1. Early detection - Improving technologies that are cost-effective and able to detect early breast cancers.
2. Improving access to health care - Ensuring that all women who are eligible for screening get their screening studies done.
3. Education -  Informing women who develop a sign or symptom of disease to get early medical attention. It’s also important to educate women who may be at elevated risk for breast cancer because of family history or other factors, that there may be measures they can take to prevent the development of the disease.
4. Research and funding for research – Ultimately, cures for breast cancer will depend on advancing research on the causes of breast cancer, the science behind what makes breast cancer grow and the development of cost-effective and efficient ways to produce new therapies, test them and, if successful, get them out into clinical application in a timely fashion.